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Thread: Friend still struggling after 4 weeks

  1. #1

    Default Friend still struggling after 4 weeks

    My friend wasn't thrilled about the prospect of breastfeeding but she was determined to try it. She struggled with miscarriages, two rounds of IVF and then was induced 4 weeks early because of preeclampsia and hellp syndrome. She of course is having severe issues with breastfeeding. She was pretty out of it for the first two days because of the low platelets and magnesium they had to put her on after a forceps delivery. She was able to try nursing when the baby was two days and while he had no issues latching on, it started to become unbearable within the next 24 hours. Her baby is 4 weeks old now and she has since seen 2 lactation consultants, had baby's lip tie and a tongue tie released, been to two sessions of craniosacral therapy, two support group meetings, been diagnosed with thrush of the breast and then upon further review been undiagnosed after they had her on of 5 days of diflucan and there was no change in the pain (she nor the baby showed any other symptoms) the cold doesn't aggrevate it so it's not Reynard's. She's been pumping half the time since it's so painful when he latches on, but it's also painful to pump. They told her to pump only for two days to give her nipples a chance to rest but she seems to be losing her supply and that started hurting just as much. She also has severe depression issues naturally and can feel it looming so she's about to give up. I am at a complete loss for her. I run my local mom to mom support group so I know a fair amount but this just baffles me. She keeps holding on thinking that tomorrow would be better but it never is. She has deep breast pain, and burning. Her nipple is always compressed and flattened but no one can seem to help the baby's latch. She's tried every single feeding position possible. She's losing her supply, although she's only ever been able to pump an ounce or two total out of both breasts since the beginning. I watched her pump when the baby was 10 days old and I never saw a let down, it just dribbled out. Any other thoughts on this one? I think she would have given up already if she didn't fear that formula would have its own host of problems thanks in advance!

  2. #2
    Join Date
    Apr 2014
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    Default Re: Friend still struggling after 4 weeks

    Hmm, have tongue and lip tie been reassessed in case they've regrown?

    I'm assuming the usual 'tricks' for a deeper latch aren't working? Flipple, breast sandwich, breast compressions, change of position... Are the mum's nipples unusually large? Jack Newman writes about some babies having to grow a little if this is the case, tho its pretty rare...

    Has the mum tried nipple shields? I usually hate them as my own battle with them was for 4 months, but if baby is having bottles in between and they allow the nipples to heal...

    How is the mama trying to heal the nipples? Does she have open sores or scabs that maybe need softening with warm water or olive oil before feeds?

    It's quite normal to not let down for a pump, especially when stressed :/ Is she trying to think of baby/look at baby, meditation.... But I'm guessing as a supporter you know the things to help her respond to a pump :/

    Not sure if any of these thoughts help!

  3. #3
    Join Date
    Mar 2014
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    Central FL
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    Default Re: Friend still struggling after 4 weeks

    I never responded well to the pump, and if the pump is hurting there is a problem with it. Do the flanges fit correctly? does she need oil because of rubbing or is too much aerola being drawn in? I went from needing large flanges down to smalls.

    If nipple is being compressed then I would suspect the tongue/lip ties or perhaps baby needs some oral motor therapy (some speech therapists do this) to help with those muscles. Baby fatiguing can cause baby to clamp down on the nipple compressing it which can cause the vasospasm which is what I experienced.
    I was willing to cope with pain but the pain was also a sign that baby didn't have a good latch and that was causing problems with milk transfer and weight gain and well as tanking my supply. My LO did need his tongue tie re-cut and we also needed about six weeks of seeing a speech pathologist and getting exercises to work on his oral motor strength to get him to the point where he could transfer milk well enough to get off the supplements and at the same time I needed domperidone to re-build my supply (since the herbs didn't work for me and the pumping wasn't effective enough either.)

    Have any herbs been tried to help her supply since she has depression problems reglain and domperidone might not be appropriate.
    Has her depression been assessed or treated? What about things like anemia and general diet and water intake? Does she have plenty of support from family/friends?
    Definitely stress will impact pumping output and lack of support from hubby and other household memebers will make trying to recover from low supply and save a troubled breastfeeding relationship very difficult.

  4. #4
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    Jun 2009
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    Default Re: Friend still struggling after 4 weeks

    Couple of quick suggestions some are already above.
    nipple shields? They need to be fitted properly and mom needs to be shown how to put them on and what to expect.
    Pump-Best kind available and has it has the fit been checked also could she be pumping on too high a setting?
    I would have to look back at thrush protocols to know if five days on Diflucan without result would definitely rule out thrush I'm not sure it would.
    If mom does not wish to formula feed has anyone discussed the possibility of donated breast milk with her?
    Also your very first comment is interesting. Mom was hesitant about breast-feeding to begin with? do you have any idea why?
    Some people have very deep-seated and private reasons that breast-feeding feels wrong to them. Now of course that on it's own would not make breast-feeding painful. However if mom is extremely tense about breast-feeding I imagine it could contribute to pain. Certainly it would also contribute to poor letdown and low supply.
    Number one of course would be supporting mom in getting help and treatment if necessary, for her depression.
    You don't mention how baby is doing how is baby doing?
    Baby is a month old now, and has been getting breastmilk for that entire month if I understand things correctly. Maybe not exclusively breast milk but has been getting some breast milk at the most fragile age and thus important time as far as the benefits of breastmilk. Of course the benefits continue for the duration, but evidence suggests that the younger baby is the more vital it is that the baby be fed breast milk. Given your friends enormous challenges I think that this could really be seen as win. Excuse the terminology I cannot think of a better way to put it I hope you know what I mean in that sense. Even if baby never gets any more milk.

  5. #5
    Join Date
    Aug 2014
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    Louisville, Kentucky
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    Default Re: Friend still struggling after 4 weeks

    Quote Originally Posted by @llli*maddieb View Post
    Number one of course would be supporting mom in getting help and treatment if necessary, for her depression.
    You don't mention how baby is doing how is baby doing?
    Baby is a month old now, and has been getting breastmilk for that entire month if I understand things correctly. Maybe not exclusively breast milk but has been getting some breast milk at the most fragile age and thus important time as far as the benefits of breastmilk. Of course the benefits continue for the duration, but evidence suggests that the younger baby is the more vital it is that the baby be fed breast milk. Given your friends enormous challenges I think that this could really be seen as win. Excuse the terminology I cannot think of a better way to put it I hope you know what I mean in that sense. Even if baby never gets any more milk.
    I wanted to echo this. I am so glad that your friend has you as a support; do you know if she has other support people that are actively present for and with her, actively and lovingly advocating for her health, baby's health? Please encourage her to seek help and support for her depression; can you sit with her while she calls resources, if she has not already?, or drive her to an appointment or support group if she is willing? It can be so hard to make that first step. I hope that she has people all around her telling her what a good and loving mother she is (even if she isn't yet in a mental/emotional space where she can really 'hear' that), and highlighting all the love and health that she has already provided her baby, as highlighted above.

    Rainlily99, you say, "She also has severe depression issues naturally and can feel it looming so she's about to give up. I am at a complete loss for her. I run my local mom to mom support group so I know a fair amount but this just baffles me. She keeps holding on thinking that tomorrow would be better but it never is."

    Are there any parts of the situation that are improving, even incrementally? Can there be ways to sort of latch on (no pun intended) to those parts as validation of her efforts and her abilities? I don't mean even improvements in breastfeeding, only, either, but even any aspect of this new parenting journey that could be points of light amidst this (ie- does she feel like she's learning babe's cues better, were her and baby able to go on a walk around the park, did baby smile at her joke, did she locate a PPD support group-- in addition to anything that might be in the nursing relationship, like slightly reduced pain, or finding a correctly fitting flange, etc)?

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